Individual provider Active NPI

Kolby Shane White, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Beaumont, TX
National Provider Identifier
1699088617
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1962 Issued in TX
Practice address
6260 Delaware St
Beaumont, TX 77706-7602
Phone
(409) 899-1538
NPI assigned
Jul 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1962 TX Primary

Addresses

Primary practice location

6260 Delaware St
Beaumont, TX 77706-7602

Mailing address

6260 Delaware St
Beaumont, TX 77706-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110819000027 TX Practitioner - Podiatry 3375713803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Triangle Foot and Ankle Specialists PAGroup PAC ID 3072643063, 4 clinicians

Practice addresses (Care Compare)

6260 Delaware St
Beaumont, TX 77706-7602
Phone (409) 899-1538

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue99
Removal of skin lesions32
Removal of nail tissue523
Removal or shaving of skin growth97
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1962TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Triangle Foot & Ankle Specialists, P.a. Foot & Ankle Surgery CurrentSince Jul 1, 2011 Accepting new patients
Reeti K Joshi, MD PA PastSince Jul 5, 2017 Accepting new patients
Beaumont Foot Specialists Inc PastSince Jul 1, 2011 Accepting new patients

Locations

6260 Delaware St
Beaumont, TX 77706
Phone (409) 833-7465

3560 Delaware St
Ste 301
Beaumont, TX 77706
Phone (409) 363-5675

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1699088617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 DELAWARE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 DELAWARE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067602",
            "telephone_number": "409-899-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KOLBY",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.